1477944908 NPI number — ELITE CARE, INC.

Table of content: (NPI 1477944908)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477944908 NPI number — ELITE CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELITE CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477944908
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 QUAIL ST STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660-2700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-511-0607
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9431 SHADWELL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92646-7213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-511-0607
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MILLIGAN
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
310-384-5556

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 300626EP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DHCS . This is a "300626FP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 300626FP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 300626DP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 300626GP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 300626AP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 300626BP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 300626CP . This is a "DHCS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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